1990; Stanley and Turner 1995; Foa et al. 2005; Sousa et al. 2006; Simpson et al. 2008; Maher et al. 2010). Also, after 10–12 weeks of treatment, pharmacotherapy only treatment has a lower response rate than the 40%–60% seen in OCD pharmacologic trials (Greist et al. 1995). The lower response rates may be related to the different standard. Simpson et al. (2008) report that 74% of patients receiving pharmacotherapy plus CBT achieved responder status when defining the response as a ≥25% reduction in Y-BOCS-SR, which is lower than ≥35% reduction in Y-BOCS-SR in this

study. The other possible reason may be associated with the low dosage of medicine. The dosage of chlorimipramine Inhibitors,research,lifescience,medical (average: around 140.0 mg/day) is lower Inhibitors,research,lifescience,medical than the recommended (150–250 mg/day; The Clomipramine Collaborative Study Group 1991; Math and Janardhan Reddy 2007). The dose of SSRIs (average: around 23.4 mg/day) taken by patients

is also relatively lower (Stein et al. 2007). The lower dosage of medication might be associated with the lower response rate in the pharmacotherapy group (Pallanti et al. 2002; Landeros-Weisenberger et al. 2009). CBT has been devised and consistently developed for OCD treatment in Western culture since the 1960s and 1970s (Taylor 2005; Foa 2010) and was introduced to China. The response Inhibitors,research,lifescience,medical rate in this study is similar to reported studies in Western populations, suggesting that CBT is applicable in different cultures, although the efficacy of psychotherapy is affected by cultural factors (Bhui and Morgan 2007). It is known that symptoms of OCD have varied little over time (pathological scrupulosity, for example, has long been Talazoparib documented) or place (similar symptoms are seen across many cultures; Ames et al. 1994; Lawrence 2000). Therefore, CCT may Inhibitors,research,lifescience,medical be an applicable therapy and is Inhibitors,research,lifescience,medical worth exploring in different cultures.

CCT is closely related to, but not the same as, CBT. First, the treatment order of CCT is fear, obsessions, and then compulsions. CBT is based on the assertion that refrain the compulsions when exposure can normalize the intrusive thoughts so that it is no longer viewed as a highly threatening cognition (Clark 2005). Second, regarding goals of treatment, CCT help OCD patients cope with intrusive thoughts because more than 90% of the general population have ever experienced intrusive thoughts (O’Neill et al. 2009), while CBT targets to normalize intrusive thoughts (Clark 2005). Third, CCT emphasizes that the fear of negative events Mephenoxalone plays an important role in the onset of OCD. A crucial step of CCT is to reduce fear with coping strategies. Fourth, our preliminary data suggest that the cognitive therapy in CCT is efficacious, whereas according to Abramowitz and his colleagues (2005), the cognitive therapy in CBT is no more effective than ERP. Fifth, CCT for OCD teaches patients to use coping strategies, whereas CBT mainly uses ERP as a therapeutic strategy (Salkovskis 1985).